A systematic review of the safety of blocking the il‐1 system in human pregnancy

Marie Eve Brien, Virginie Gaudreault, Katia Hughes, Dexter J.L. Hayes, Alexander E.P. Heazell, Sylvie Girard

Research output: Contribution to journalReview articlepeer-review

Abstract

Blockade of the interleukin‐1 (IL‐1) pathway has been used therapeutically in several inflammatory diseases including arthritis and cryopyrin‐associated periodic syndrome (CAPS). These conditions frequently affect women of childbearing age and continued usage of IL‐1 specific treatments throughout pregnancy has been reported. IL‐1 is involved in pregnancy complications and its blockade could have therapeutic potential. We systematically reviewed all reported cases of IL‐ 1 blockade in human pregnancy to assess safety and perinatal outcomes. We searched several data-bases to find reports of specific blockade of the IL‐1 pathway at any stage of pregnancy, excluding broad spectrum or non‐specific anti‐inflammatory intervention. Our literature search generated 2439 references of which 22 studies included, following extensive review. From these, 88 different pregnancies were assessed. Most (64.8%) resulted in healthy term deliveries without any obstetri-cal/neonatal complications. Including pregnancy exposed to Anakinra or Canakinumab, 12 (15.0%) resulted in preterm birth and one stillbirth occurred. Regarding neonatal complications, 2 cases of renal agenesis (2.5%) were observed, and 6 infants were diagnosed with CAPS (7.5%). In conclusion, this systematic review describes that IL‐1 blockade during pregnancy is not associated with increased adverse perinatal outcomes, considering that treated women all presented an inflammatory disease associated with elevated risk of pregnancy complications.

Original languageEnglish (US)
Article number225
JournalJournal of Clinical Medicine
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2022

Keywords

  • Anakinra
  • Canakinumab
  • Human
  • IL‐1 blockade
  • Inflammation
  • Pregnancy

ASJC Scopus subject areas

  • Medicine(all)

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